NPI | 1366678542 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0049269) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL-3264) |
Enumeration Date | 2009-06-02 |
Last Update Date | 2020-03-26 |